Journal of

Background and Aim: Medicine as a strategic commodity and basic needs of the most people in the country is important. According to the necessary recognition correct pattern of drug use, this study is conducted to measure the pattern of drug use among Ardabil city families.

Materials and Methods: A cross -sectional descriptive study was conducted on 1000 randomly selected families from Ardabil city in 2010. Necessary information was gathered by interviewing one of the oldest people in the family. Collected data was analyzed using descriptive statistical methods in SPSS.16 software.

Results: 485(48.5%) of study people were female and rest of them were male. The mean age of samples was 41.6(SD=14.1). From all families 22% uses the drugs in home for curing diseases by self diagnosis. 10.9% of them do not respond to doctors non medical advice and prefer the doctor to prescribe drugs otherwise they refer to another doctor.

Conclusion: Results showed that the drug use behavior between Ardabil city families was inappropriate and decreasing irrational use of drugs by providing necessary information to people regarding optimal use of medicine was necessary.

Background and Aim: Changes in political, economic, social, scientific and technological circumstances have a major impact on organizational performance. In such circumstances, the success of organizations depends on their ability to cope and adapt to changing environmental factors. This study investigated the relationship between organizational participation(team orientation, capability development and empowerment) and the organizational adaptability (change, customer orientation and organizational learning) in Imam Khomeini Hospital staff.

Materials and Methods: This cross-sectional study was performed on 114 staffs of Imam Khomeini hospital, Tehran University of Medical Sciences who were selected by random sampling. Data were collected by Denison questionnaire (2006 version), which was confirmed validity and reliability. Data were analyzed with spss17 and statistical methods like the mean, standard deviation and correlation coefficients.

Results: The results showed that the rate of the organizational involvement and adaptability of the staffs was 53.44% and 52.37% respectively. The Pearson correlation analysis showed a positive correlation coefficient (p<0.01, r=0.743) between two variables of organizational involvement and adaptability.

Conclusion: With increasing organizational involvement of the staffs increases their organizational adaptability

Background and Aim: Embryonic stem cells are identified with two unique characteristics. First, they can be maintained and expanded as pure populations of undifferentiated cells, a characteristic which is known as self renewal aspect of embryonic stem cells. Second, these cells can give rise to all body cell types. In the current study, we used a feeder-free condition to differentiate mouse embryonic stem cells into lymphoid lineage by IL-7 and FLT-3 ligand.

Materials and Methods: Mouse embryonic stem cells cultured on mouse embryonic fibroblasts were separated from the feeder layer. Then, embryoid bodies were formed from mouse embryonic stem cells. Following that, differentiation was performed by FLT-3 ligand and IL-7. In order to demonstrate the differentiation into lymphoid lineages, the expression of CD25, CD19 and CD3 was assessed by RT-PCR technique on days 7 and 14.

Results: After 14 days of differentiation into lymphoid lineages by defined factors, RT-PCR results showed the expression of CD25 and CD19 markers.

Conclusion: In all previous studies, mouse embryonic stem cells were differentiated into lymphoid lineage by OP9 stromal feeder cells. In this study, a feeder-free condition was used to differentiate mouse embryonic stem cells into lymphoid lineage. It is hoped that the present study can lead to new insights in cell therapy of lymphoid deficiency disorders.

Background and Aim: The aim of this study was to evaluate bacterial contamination of keyboards of computers located in various wards of Vali-e Asr Teaching Hospital, Birjand, Iran.

Materials and Methods: In this study, all computer keyboards in various wards of Vali-e Asr Hospital were sampled (n=24). Then, the samples were sent to Microbiology Research Laboratory at Birjand University of Medical Sciences and were cultured on Blood ager, Manitol Salt ager and Eosin Methylene Blue media. The isolated bacteria were identified based on their colonial morphology and biochemical characteristics.

Results: A total of 26 samples from 24 different computer keyboards of 16 different wards were obtained. Two keyboards of Infectious Diseases and Neurology wards were routinely disinfected at the end of every shift. All samples(100%) showed contamination to different bacteria. The keyboard of the computer located in Internal Medicine ward(women's division) was the most contaminated one. In total, 13 different bacterial spp. were isolated from keyboards of different computers. The species belonging to Enterobacteriaceae family(61.5%) were the most common contaminating bacteria followed by Bacillus spp(30.7%).

Conclusion: Based on the results, all the sampled keyboards were contaminated by at least one bacterial spp. Therefore, it is necessary to pay more attention to the fact that computer keyboards in hospitals should regularly be disinfected.

Background and Aim: Quality of printed papers in 4 four medical journals affiliated to one of the universities of medical sciences in Iran was assessed based on methodological and statistical methods.

Materials and Methods: In this cross sectional study conducted in 2010, out of all articles published between the years 2002 to 2008 in one of the universities of medical sciences for affiliated journals that were equal to 1568, a sample of 162 articles were selected with Multi-stage stratified sampling method . For data collection, standard questionnaire was used to develop an information form. One sample t-test and Kruskal-Wallis test were used to compare scores from different parts of article.

Results: Cross sectional studies with 61.7% (100 papers) formed most of studies. Median of authors and number of references for each article were 3 and 19, respectively and 10% of articles had more than 35 references. Material and methods with 3.53 points from 4 points (88.2%) earned the mighest score which was of high quality and conclusion achieved the lowest score. Also p-value has been reported correctly in 102 articles (81.6%). In 95 articles (58.6%) results were not compare with the similar internal articles whereas only in 21 articles (13%) comparison was not made with similar external researches.

Conclusion: The present study showed that the overall quality of the medical articles is not desirable. Hence, employing experts in research methods and statistics in various medical studies can improve the quality of articles in this branch of science.

Background and Aim: The international book fair is an opportunity for school libraries. This study was conducted to determine the role of the Tehran international book fair to provide books for school libraries.

Materials and Methods: The study is a descriptive survey. Employees and authorities worked in libraries affiliated to Tehran and Beheshti Medical Sciences Universities consisted the study population. Sample size included 41 individuals(26 staff and 15 officials). For data analysis descriptive statistics by using one sample t- test, chi square, ANOVA and correlation were used.

Results: The highest average score dedicated to choose books in school libraries was a scale of a 3/35± 0/89. With an average score of 3/06±0/07, the role of International book fair in supplying books for school libraries was moderate. Correlation test showed that problems of school libraries had the highest correlation(r=0/36) while the lowest correlation was related to the possibility of book supply(r =0/067).

Conclusion: The international book fair does not have an effective role in supplying books for school libraries. It is necessary to use new approaches to supply books for academic libraries.

Background and Aim: Organizations have to establish modern management systems to progress and to obtain maturity. One of the techniques which started in Europe in the last two decades and is considered in management area of country during recent years is the model of organizational promotion (EFQM). The purpose of this study was Performance Evaluation of Rajaei Hospital Based on «EFQM» Organizational Excellence Model.

Materials and Methods: This cross-sectional study was conducted in year 2010 in Qazvin Rajai Hospital. Data collection tool, was EFQM organization Excellence Model questionnaire which was completed by all the managers. Validity and reliability of questionnaire was calculated. Results were analyzed using descriptive statistics.

Results: Results indicated that this hospital has acquired 99.183 scores out of 500 in enablers factor(88.36 percent of optimum score). Also has gained 183.71 scores out of 500 (36/75 percent of optimum score). Overall, this hospital has obtained 366.7 scores out of 1000 as the total score in the model for performance evaluation in year 2010.

Conclusion: Findings indicated that based on Excellence model criteria, this hospital is in a moderate level. Applying this model for Iranian hospitals which often meet serious problems in this area is informative and practical. Strong systematic view, paying attention to organizational process-based management and being result-oriented are advantageous of using this model.

Background and Aim: In recent years demand for a variety of cosmetic surgery, especially rhinoplasty has been increased in our country. Some research has shown that psychological factors influence the request for cosmetic surgery. Therefore, this study was performed to examine the dimensions of perfectionism.

Materials and Methods: The study was a causation - comparative study conducted in the spring and summer of 2010 in yasouj city. Fifty people undergone rhinoplasty surgery were compared with 50 subjects as controls. For the comparison of the dimensions and subscales of perfectionism, Frost multidimensional perfectionism scale was used. Data was analysed using SPSS software and dependent t test.

Results: Women using rhinoplasty were more than men. Most participants were single and between 26-30 years. The majority of the subjects had university education and their income level was between 7010000 to 9000000rials. There was significant difference in the Perfectionism subscale between the two groups in the Individual standards (P=0/001), order (P=0/001), concern about mistakes (P=0/001), parental criticism (P=0/001), doubt about action (P=0/013) and parental expectations (P=0/04). Generally the study showed significant difference in Perfectionism between the two groups(P=0/001).

Conclusion: People who had cosmetic rhinoplasty surgery were more perfectionists and were often negative perfectionists.

Background and Aim: Hospitals are among the most important establishments providing health services, in which -- due to special hazards -- the observance of safety principles is of great importance. This research aimed to study the safety conditions at educational hospitals of Shiraz University of Medical Sciences(SUMS).

Materials and Methods: This cross-sectional descriptive study was conducted in all educational hospitals in Shiraz and their safety status was investigated using safety audit technique. To this end, audit checklists were prepared and completed through observation, interview with managers and officials of various departments as well as studying the related documents. Then, based on the realization of safety requirements, hospitals were classified into three levels of poor (lower than 50%), medium (5o-75%), and good (higher than75%).

Results: The mean realization of safety requirements in the studied hospitals was 58 percent. The highest and lowest levels of realization of safety requirements were related to radiation safety and safety management, respectively. Safety status was evaluated as poor in 25% and medium in 75% of the studied hospitals.

Conclusion: The safety conditions of the studied hospitals, especially as regards safety management, emergency response plan, and fire safety aspects were relatively poor. The most important reason for that was the lack of clarity of responsibilities and of safety organizational structure. To improve the safety status, hospitals are required to establish the Occupational Health and Safety Management System (OHSAS 18001).

Background and Aim: This study aimed to assess the factors affecting organizational innovation and entrepreneurship at medical sciences universities in Iran. Such universities provide a wide range of services and products including prevention (hygiene), treatment (medical care), rehabilitation and palliative care, as well as their important mission, i. e., higher education and research in related fields.

Materials and Methods: In this study, the researchers developed and examined a model for organizational innovation and entrepreneurship, including 16 factors classified into structure, content (behavior) and context (periphery) of the subject.
The data collection instrument was a pre-structured questionnaire containing 58 core questions on the Likert scale. The validity of the questionnaire was computed by elites, and its reliability was estimated using Cronbach's Alpha (94%). Of 389 questionnaires, 325 were collected and their data were analyzed by SPSS software, version 18.

Results: The three factors -- structural (structure), behavioral (content) and peripheral (context) -- which affect innovation and entrepreneurship are not favorable at medical universities.

Conclusion: This study shows that structural, behavioral and peripheral factors are the most important, which affect innovation and organizational entrepreneurship at medical sciences universities.

Background and Aim: Candida spp can colonize in oral cavity in immunocompromised patients and can lead to candidiasis. Because of immunocompromised condition in patients with Down syndrome, this study aimed at the colonization rate of candida spp in the mouths of such patients.

Materials and Methods: This descriptive cross-sectional study was carried out on 53 patients with Down syndrome (29 males and 24 females) within the age range of 4-31 years (mean age: 11.1 years) and supported by the welfare organization, Tabriz branch.
The samples were taken from the dorsal and buccal parts of tongues using sterile swabs, and were cultured on Sabouraud Dextrose Agar (SDA+ Chloramphenicol) and corm candida agar.
Determination of candida species was based on phenotype characteristics and chlamydoconidia production in Corn Meal Agar containing Tween 80.

Results: Altogether 60 isolates of candida spp were isolated from 46 positive patients [26 males (56.52%) and 20 females (43.48%)]. C.albicans with 35 cases (66.03%) were the most frequent isolate and C.dubliniensis with 9 cases (16.98%), C.krusei with 7 cases (13.20%), C.globrata with 5 cases (9.43%) and C.tropicalis with 4 cases (7.54%) were the following ranks. In 12 patients (22.4%), there were more than one species of candida in their oral cavity.

Conclusion: Due to the immunocompromised condition in patients with Down syndrome caused by a decrease in IgA and the activity of H2O2 (main destructive agent of C.albicans), the necessity of colonization rate of Candida in such patients is recommended.

Background and Aim: Social capital is one of the social determinants of health, which might have an important role in health inequalities. The amount of social capital gained by individuals differs depending on social circumstances in fact, not all individuals can equally benefit from social resources of social capital. This study aims to examine the effect of social capital dimensions on being afflicted by cancer in patients referring to Cancer Institute of Tehran.

Materials and Methods: This is an analytic-descriptive study, the population of which included all patients aged over 14 and affected by stomach, colon and breast cancers, referring to Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. The sample consists of 106 subjects who have been chosen using the classified probability sampling method. The data collection device was a questionnaire together with a structured interview. Social capital emphasizes the two structural and cognitive dimensions. Moreover, it stresses personal social capital.

Results: Health inequalities and cancer are the results of simultaneous interaction between the different dimensions of social capital and behavioral/psychological and biological factors. People enjoying similar social capital in life experience cancer-related stress and unhealthy behavior in different ways

Conclusion: An increase or decrease in any of the social capital components can lead to a change in the number of those getting the disease.

Background and Aim: Problems such as hypothyroidism and aggressiveness may lead the organizations to reduced and seek to increase further behaviors that have the benefits for organization, such as productivity. One of the factors that produce productivity organization is organizational citizenship behavior. The aim of this study was to determine the relationship between the component of organizational citizenship behavior with human resources productivity among selected hospital's staff in Tehran University of Medical Sciences and Shahid Beheshti University of Medical Sciences.

Materials and Methods: This research was carried out in 6 Hospitals of Tehran University of Medical Sciences and Shahid Beheshti University of Medical Sciences by attitude approach survey and data has been collected via questionnaire that was distributed among 429 staff of these hospitals by 2 stage stochastic sampling method. Research methodology has been descriptive, analytical and cross sectional. For survey to accept or reject the study hypothesis, was performed spearman correlation and regression tests with SPSS software.

Results: The study results showed that, in our population perception, there was a significant relationship between organizational citizenship behavior and productivity in people. This means that, in these hospitals, implementation of organizational citizenship behavior has effect on the amount of peoples productivity.
Conclusion: In this study, the effect of magnanimity and look over component on productivity had different results in the studied hospitals. But results are same as the initiative of individual creativity component. In addition the potential reasons for probable low levels of these components and their related indices have been analyzed and the solutions have been presented for their improvement.

Background and Aim: Work engagement is defined as a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption. Since the quality of care delivery to patients depends on nurse's practices, the objective of this study was to determine work engagement & its effective factors among nurses of general hospitals of Shiraz University of Medical Sciences.

Materials and Methods: This cross sectional study was performed among 273 in-patient nurses of Namazi and Faghihi hospitals using 2 stages of sampling. Our questionnaire was validated by experts opinions and Cronbach's alpha index (86%). Descriptive statistics and correlation tests were used for the analysis of data by SPSS.

Results: According to the results obtained, mean work engagement was 58.95 ± 10.51 and there was a significant correlation between work engagement and organizational - supervisor support, organizational justice, job characteristics, reward & recognition, organizational citizenship behavior, organizational commitment, job satisfaction, turnover( p<0.05). The relationship between work engagement and reward was the strongest(r=0.512).

Conclusion: The results imply the importance of work engagement and its related factors. Nurses are one of the biggest health system groups, and their burnout disadvantages hospitals and community. Thus, work engagement should be noticed in all policy-making related to nurses.

Background and Aim: Although vancomycine is used for the treatment of methicillin resistant Staphylococci, but vancomycine alone might not be effective for the treatment of methicillin resistant Staphylococci in compromised host. In the same time antimicrobial activity of cefepim on gram positive bacteria especially Staphylococci is well known. In this study the synergism effect of cefepim and vavcomycin on positive and negative coagulase Staphylococci in vitro condition was investigated.

Materials and Methods: In total, 100 clinical samples of coagulase positive and negative Staphylococci were isolated from urine and blood samples from patients in Imam Khomeini Hospital during one year and identified .The modified Bauer-Kirby were used for the antibiotic susceptibility and macrodilution method for the MIC according to NCCLS procedure.

Results: The results showed that after adding vancomycin to cefepime in concentration from 0.05+ 0.5 , to 0.8+8 , growth reduction reached from 3.5% to 100%.The synergism effect of the two mentioned antibiotics on coagulase negative Staphylococci resistant to methicillin were shown that from concentration of 0.05+ 0.5 to 0.8+8 , a reduction in growth from 4.5% to 100% was observed.

Conclusion: The results of this study showed that vancomycin and cefepime has synergic effect on Staphylococci

Background and Aim: Health information System (HIS) is a comprehensive software used to unify and transfer hospital data effectively. It is vastly employed to improve input quality, decrease data-transfer time, increase satisfaction level, promote health services quality, and minimize hospital costs.

Materials and Methods: This is an applied-descriptive study. The research population consisted of 120 HIS users who worked before and after the HIS application at Masih-Daneshvari Hospital. For data collection purposes, a questionnaire was used. The data were then analyzed with SPSS software, and descriptive and inferential statistical methods.

Results: According to data analysis, the application of the existing communication system among the different sections and wards was very good (81%), the accessibility to patient medical information and facilitating treatment processes were good (44% and 61%, respectively), and the analysis of budgeting data (11%), the possibility of clinical researches (19%), the presentation of guides for operators (18%), and the accessibility to statistical and financial data (17% and 22%, respectively) were assessed as poor.

Conclusion: The results of this survey show that the application of Hospital Information System has a positive effect on accuracy, facility, and treatment processes, and emphasize the importance of programming to enhance the quality of hospital services.

Background and Aim: Pityriasis versicolor is a fungal disease with causative agent Malassezia species which is an opportunistic and lipophilic yeast .With regard to liphophilic nature of the yeast, this study was carried out for evaluation of relationship between pityriasis versicolor and triglyceride and cholesterol levels.

Materials and Methods: This cross - sectional study was performed on 1500 subjects ranging from 10 to 50 years old in Isfahan province. Of total subjects, 105 had pityriasis versicolor. Disease confirmation was based on direct examination, inoculation and culture on Dixon media. Measurement of total cholesterol and triglyceride of patients and control groups in fasting manner was done by Auto analyzer RA 1000. Data of patients including age, education level and job was gathered by questionnaire and analysis of results was done by t student, chi square and Pearson correlation tests.

Results: Prevalence of infection was 7% in the test group. Maximum frequent rates of infection was %3.13 in age group 20- 30 years and minimum in age group 30-40 years(% 0.87). The highest rate of total cholesterol levels was seen in age group 40-50 years (mean 215 mg/dL) and the lowest was in age group 10-20 years(mean 205 mg/dL).

Conclusion: Total cholesterol and triglyceride levels in patients were higher than the control group but the difference was not significant(P<0.05). No correlation was seen between pityriasis versicolor and increase in the total cholesterol and triglyceride levels in patients and control groups.

Background and Aim: Internal Evaluation is a process of providing evaluative-descriptive information based on the value and significance of educational objectives, operations and results to direct decisions, responses, information and research processes.

Materials and Methods: In this research, studying the opinions of faculty members, students, and graduates, the educational system of Medical Laboratory Sciences Department at Tehran University of Medical Sciences (TUMS) was evaluated in the year 2010. The aim the study was to remodel and adjust the educational system with the society's needs and to promote the educational quality. The employed method was a cross-sectional, descriptive one and consisted of 10 procedural steps in eight sections dealing with the evaluated factors such as faculty members and students, and the satisfaction expressed by students.

Results: The results of the study showed that the average of the eight investigated sections was 70.6% for the Department of Medical Laboratory Sciences, which can be interpreted as desirable.

Conclusion: Internal evaluation can be considered as one of the best methods of improving the quality of education in the faculty of Allied Health Sciences School

Background and Aim: Tumor dissemination via blood to distant organs is the main cause of death. Therefore, there is a critical need to set up sensitive methods for the early detection of circulating tumor cells(CTCs) and disseminated tumor cells(DTCs) in peripheral blood (PB) and bone marrow(BM) specimens of breast cancer patients. The aim of this research is to study the detection of micrometastasis using MUC2 in such patients.

Materials and Methods: In this study, PB and BM samples were collected from 50 breast cancer patients after operation and before adjuvant therapy. Mucin 2 (MUC2) was used as a tumor marker and its transcript level in the sample patients was analyzed using gene specific, quantitative real-time PCR reaction with SYBR Green technology. Samples from 20 healthy individuals were used as negative controls. HPRT was used as a reference gene.

Results: MUC2 mRNA was detected in 8 (16%) of PB and BM samples. MUC2 mRNA was not detected in PB samples of healthy individuals. The relapse rate among MUC2-positive patients was higher than MUC2-negative patients and it was statistically significant in BM (P<0.05).

Conclusion: This study shows that MUC2 can be a suitable marker for the detection of micrometastasis in breast cancer patients at early stages of cancer and that it may provide the basis for identifying women at risk of relapse.

Background and Aim: In strategic planning, there are several procedures to perform internal assessment or strength and weakness of organizations. Among other methods created for this purpose, Wiseboard model is the one in which the following six internal dimensions are considered: Organizational Structure, Leadership, Coordination, Reward System and Communication. This study measures three of these variables in hospitals of Tehran University of Medical Sciences (TUMS).

Materials and Methods: This survey is a descriptive, analytical and cross-sectional study conducted during 2010 and 2011. The research population comprised all those working at TUMS hospitals from which a random sample of about 580 people was selected. The questionnaire's reliability was estimated to be 91% and the data were analyzed by the SPSS software.

Results: Of the subjects, 75.4% were below diploma level, 13% above diploma, 7.8% higher diploma, 66.4 bachelor holders, 2.6% master holders, and 5.4% had a doctoral degree or higher. Some 72.6% of the subjects were in Clinical and 19.8% in Nonclinical fields. The mean values of Goal Setting, Organizational Structure, and Leadership came out to be 24.47, 20.37, and 22.06, respectively.

Conclusion: Based on the findings of this research study, TUMS hospitals have weaknesses in some aspects and they need improvement in some areas in the following order: Organizational Structure, Leadership, and Goal Setting.